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Allegation

Whilst registered as a Practitioner Psychologist and working at Guy's and St Thomas' NHS Foundation Trust:

1. You breached professional boundaries in relation to Patient A, in that:

(a) Between 7 November 2015 and April 2016, you encouraged Patient A to leave her husband;

(b) Between 7 November 2015 and April 2016, you encouraged Patient A to reduce contact with members of her family;

(c) Between 7 November 2015 and April 2016, you provided Patient A with your personal mobile telephone number;

(d) Between 7 November 2015 and April 2016, you would sometimes stand closer to Patient A than she was comfortable with and you occasionally touched her leg;

(e) Between 5 February 2016 and April 2016, you maintained contact with Patient A following her discharge from the service;

(f) Between 5 February 2016 and April 2016, you visited Patient A’s home on a number of occasions following her discharge from the service;

(g) On or around 5 February 2016, you took Patient A out for lunch;

(h) On or around 5 February 2016, you ordered a bottle of wine whilst having lunch with Patient A;

(i) On or around 5 February 2016 said words to the effect of “our relationship will change. Right now we’re doctor and patient, we’ll move beyond that and we’ll start to become friends and maybe more” or words to that effect.

2. You did not obtain consent from Patient A to:

(a) take notes and/or to subsequently include Patient A's information in an article;

7. By reason of your misconduct and/or lack of competence your fitness to practise is impaired.

Finding

Preliminary matters

Proof of Service

1. The Panel accepted the advice of the Legal Assessor. The Panel had sight of a letter dated 28 June 2018, sent to the Registrant at his registered address, giving Notice of the hearing, and determined that service had been complied with in accordance with the Health and Care Professions Council (Conduct and Competence Committee) (Procedure) Rules 2003.

Proceeding in absence

2. The Panel heard and accepted the legal advice from the Legal Assessor, who referred it to the case of GMC v Adeogba [2016] EWCA Civ 162, and the principles to be considered when deciding whether or not to proceed in the absence of the Registrant. The Panel had in mind the need to exercise its discretion to proceed with the utmost care and caution, particularly because the Registrant was not represented.

3. The Panel noted that the Registrant had not responded to the Notice of today’s hearing, but was satisfied that he was, or should be, aware the hearing was due to go ahead today and that, in the event that he did not attend, the hearing could go ahead in his absence. The Registrant had not responded to the HCPC Notice of Allegation sent to him on 7 February 2018, or any other correspondence sent to him by the HCPC in relation to these proceedings, except for a single letter dated 9 January 2018. In that letter the Registrant stated, “In response to your letter dated 14/12/2017 and your request for me to respond to the new amended allegations made recently by Patient A.” In light of that letter, the Panel was satisfied that the Registrant was fully aware that proceedings were being taken against him in relation to the complaint made. The address on that letter was the same as the Registrant’s address as registered with the HCPC.

4. The Panel noted that the Registrant faced serious allegations and there was a clear public interest in the matter being dealt with expeditiously. The Panel considered an adjournment would serve no useful purpose, because it seemed most unlikely that the Registrant would attend on another occasion, given his complete lack of engagement since January 2018. Furthermore, the Panel noted he had not requested an adjournment. In light of that complete lack of engagement, the Panel decided that the Registrant had voluntarily waived his right to be present and his right to be represented at this hearing. The Panel took into account that there were three witnesses attending on behalf of the HCPC and that the complaints in this case date back to 2015. There was, therefore, a concern about the effects of any further delay on their memories if the matter were to be adjourned.

5. The Panel concluded that it was in the interests of justice that the matter should proceed notwithstanding the absence of the Registrant. The Panel would draw no adverse inferences from the Registrant’s non-attendance and would take into account any documents within the papers that furthered his case.

Application to amend

6. At the outset of the hearing, Ms Chaker applied to amend the particulars to adjust the dates in 1(a), 1(b), 1(c), 1(d) and 3(a) to more accurately reflect the evidence of Patient A and the date upon which she was first referred to the Neuro-Rehabilitation Enhanced Transition Team (“NETT”). Ms Chaker submitted that such an amendment would not make the case against the Registrant more onerous, but in fact narrowed the dates of the allegation. She said it was clear from the Registrant’s letter, dated 9 January 2018, that he was aware of the correct dates, because he stated that he was not in contact with Patient A until late 2015, when she was referred to NETT. It followed that the references to 2014 were clearly entered in error.

7. The Panel heard and accepted the legal advice from the Legal Assessor that it could amend the Allegation provided it was satisfied that it was fair to do so and that the proposed amendments could be made without injustice. The Panel noted that, whilst the Registrant had not been informed of the proposed changes, they were clearly the result of a typographical error and to allow the amendments would not result in the allegation being more onerous. The Panel was satisfied that to grant the application would not cause any injustice to the Registrant and therefore decided to allow the amendments requested.

Further application to amend

8. On day two of the hearing, Ms Chaker made an application to amend Particular 3(e), it having become apparent that a further typographical error had occurred, in that part of Particular 4 had been replicated in Particular 3(e). She also made an application to amend Particulars 1(g) and 1(h) to delete the words, “following Patient A’s discharge from the service” from both of those particulars. This followed the evidence of Patient A, during which she clarified the date of her discharge from NETT as 5 February 2016, and also that being the date on which she says the Registrant took her out to lunch. Ms Chaker said the mischief of the charge was taking Patient A out to lunch and whether she had actually been discharged or not at that particular moment did not impact upon the gravamen of the Allegation. She said that since it could not be said definitively that Patient A had in fact been discharged at the time of the lunch and since it made no difference to the nature of the allegation, there would be no injustice in deleting the words referring to discharge.

9. The Panel heard and accepted the legal advice from the Legal Assessor that it could amend the Allegation provided it was satisfied that it was fair to do so and that the proposed amendments could be made without injustice. With reference to Particular 3(e), it was clear to the Panel that the inclusion of the words “confidential information about another patient and/or other patients with Patient A” within Particular 3(e), where they made no sense, was an error, the exact same words appearing in Particular 4. The Panel was satisfied that in striking out those words in Particular 3(e), there would be no injustice to the Registrant and it therefore allowed the application.

10. In relation to the application to remove the words, “following Patient A’s discharge from the service” from Particulars 1(g) and 1(h), the Panel agreed with Ms Chaker’s assertion that the mischief of those particulars was the taking of Patient A out to lunch, either on or around the day of her discharge, particularly when considered together with the stem of Particular 1, namely that the Registrant breached professional boundaries in relation to Patient A. Whether Patient A had in fact been discharged at the time of the lunch did not, in the Panel’s view, alter the nature or seriousness of the particular and therefore the proposed amendments could be made without injustice. Accordingly, the Panel allowed this application as well.

Witnesses

11. The Panel heard from three witnesses called on behalf of the HCPC:

• Patient A – a patient of the Registrant;

• AW - Clinical Manager of the Neuro-Rehabilitation Enhanced Transition Team at the Trust;

• HC - Clinical Lead of the Neuro-Rehabilitation Service at the Trust.

12. The Registrant did not attend. He had, however, provided a statement dated 8 June 2016, in response to the concerns raised by Patient A’s General Practitioner (“GP”), and had also sent a letter to the HCPC dated 9 January 2018.

Background

13. The Registrant is, and was at all material times, registered as a Practitioner Psychologist with the HCPC.

14. From 17 November 2014, the Registrant was a locum Band 8A Clinical Neuropsychologist in NETT at Guys and St Thomas’ NHS Foundation Trust (“GSTT”). He was recruited to his post by HC and was line managed by AW.

15. In 2014 the NETT was a new team, having received funding on 1 November 2014. It was set up to work with patients living in the community who had been discharged from acute hospitals or specialist neuro-rehabilitation units earlier than expected. The service users had complex neurological conditions such as brain injuries or multiple sclerosis.

16. On 5 October 2015, Patient A, a married mother with two young children, woke up and was unable to stand. She was taken to the Accident and Emergency Department at King’s College Hospital. She said nobody knew what was wrong with her, but after a few days on the ward a psychologist suggested she may have a condition called Functional Neurological Disorder (“FND”). Patient A said she was in hospital for six weeks. She could not walk, stand, or sit up. She was completely bed-bound and could not even move to a chair. She described it as very frightening and she said how she missed her children, who at the time were aged one and three.

17. Patient A described how, after her fifth week in hospital, she became desperate and frightened. She still did not have a diagnosis and therefore no treatment plan and she was told that she was to be discharged from the hospital to a hospital bed in her own living room at home. It was at this time that she was referred to NETT and the Registrant came to see her to decide whether she was appropriate for treatment in the community. Patient A said that the Registrant told her he knew what was wrong with her and he diagnosed her with FND. He said he could treat her at home so she could be with her children. This, she said, made her and her husband feel relieved and happy.

18. Patient A was accepted as a patient of the NETT at GSTT on 7 November 2015 and discharged on 5 February 2016. She had complex needs and was described by AW as being particularly vulnerable.

19. The Registrant took the lead on all therapeutic intervention with Patient A until her discharge on 5 February 2016. Unbeknownst to AW and HC, it was alleged that the Registrant continued to see Patient A after she had been discharged from the service. However, no concerns were indicated until a Safeguarding Alert was raised on 5 May 2016 by Patient A’s GP, following Patient A’s decision to cancel all further meetings with the Registrant on the advice of her GP. An investigation was then initiated by Southwark Social Services.

20. As part of that investigation, further concerns were identified in relation to record-keeping and information governance. The allegations in this case concern the alleged behaviour of the Registrant in his interactions with Patient A both during the time that he was treating her and also after she had been discharged from the NETT.

21. A questionnaire was provided to the Registrant by HC requesting the Registrant’s position in relation to each of the concerns identified at that time. The Registrant provided his response on 8 June 2016. He denied the allegations made against him and said that “any contact [he had] with [Patient A] ha[d] been professional and conducted on that basis”.

22. In that statement, the Registrant suggested that Patient A’s motivation to make false allegations against him might be because she thought he was involved in the initiation of an investigation by Social Services into her claim of funds for her care package.

23. In a letter dated 9 January 2018 (his only correspondence with the HCPC), the Registrant denied the allegation that he had sometimes stood closer to Patient A than was comfortable and occasionally touched her leg. He denied saying words to the effect of “Our relationship will change. Right now we’re Doctor and patient, we’ll move beyond that and we’ll start to become friends and maybe more.” He also denied the allegation that any of his actions had been sexually motivated, stating that he had always conducted himself in a professional manner.

Decision on Facts

24. In reaching its decisions on the facts, the Panel took into account the evidence provided by the witnesses called by the HCPC and all the documentary evidence. The Panel also took into account the submissions made by Ms Chaker on behalf of the HCPC. The Registrant was not present; however, the Panel did take into account his statement in response to the concerns raised by Patient A’s GP, dated 8 June 2016, and also his letter to the HCPC dated 9 January 2018. The Panel accepted the advice of the Legal Assessor and bore in mind that, notwithstanding those admissions, it was for the HCPC to prove its case on the balance of probabilities. It was not for the Registrant to disprove the allegations.

25. Patient A gave detailed oral evidence in answer to extensive questioning by the Panel. The Panel found her to be a broadly plausible and unguarded witness, who was clear in her interpretation of events. She was at times not open to considering alternative explanations and motivations for the alleged actions of the Registrant, instead maintaining consistency in her interpretation of events. Her answers were often digressive, but repetition of key aspects of questions helped her to re-focus and provide useful evidence. In a number of areas she was able to offer considerable detail, such as in relation to the lunch with wine that it is alleged took place. Such detail added to her credibility as a witness.

26. The Panel found AW to be a compelling and reliable witness. She had an excellent recall of events and was entirely consistent throughout her evidence. She was fair minded, credible and quick to admit when she was unable to answer any question. She provided helpful evidence about the Registrant’s character, describing him as follows: “[the Registrant] appeared to be a professional, charismatic and very confident person and clinician, however there were times that he was perceived by others to be unprofessional (making lots of jokes at inappropriate times), over-confident and slightly arrogant in his manner and demeanour.” In oral evidence, she said that the Registrant could sometimes be abrupt and was very difficult to challenge.

27. HC gave clear, reliable and fair evidence. She did her best to give full answers to all questions. The Panel recognised that, by virtue of her senior role, she was removed from the day-to-day work activities of the Registrant, but nevertheless she was able to give valuable insights in a number of areas.

Particular 1(a) - proved

28. Patient A gave evidence that, during the sessions she had with the Registrant, he told her on more than one occasion that she should leave her husband. Her recollection was that the Registrant’s encouragement of her to leave her husband began when the Registrant was told that her husband had questioned exercises being used in a physiotherapy session. She further explained in her oral evidence that her family found themselves in a desperate and extremely stressful situation. This had put strain on her marriage and she recalled mentioning, when asked by the Registrant, occasions that she had argued with her husband.

29. Patient A explained that her view, in hindsight, is that to begin with the Registrant merely ‘implied’ that she should leave her husband. Every session involved detailed questioning about their marriage, including their sexual relationship. He would regularly express the view to Patient A that her husband “did not have [her] back” and a perception developed that her husband was not supportive and was obstructing her treatment. She said that the Registrant would ask her intimate personal questions about her interactions with her husband and seemed intent on undermining their relationship. Patient A said that the Registrant told her she could not trust her husband and that he did not care for her. She described how this “drove a wedge between me and my husband”. She also told the Panel how the Registrant even went so far as to provide direct advice in relation to legal aspects of divorce and where she would stand financially. Patient A said, “It felt like a long process of isolating my husband so that I became increasingly dependent on [the Registrant], who said he was the only person who understood me.”

30. In his statement dated 8 June 2016, the Registrant said, “I have never encouraged [Patient A] to leave her husband.” He said that Patient A stated her intention to leave her husband, but that his therapeutic intervention with both Patient A and her husband led to a significant improvement in their relationship.

The Panel’s decision

31. The Panel found the evidence of Patient A to be clear and compelling. The Panel found that the Registrant engaged in a pattern of behaviour that provided encouragement to Patient A to leave her husband. He was critical of the husband, such as remarking that he did not have her ‘back’, and then, unsolicited, he researched and provided information concerning the financial and other aspects of a separation. Patient A said that “every session required ‘husband bashing’” and this contrasted with the Registrant’s assurances that he was the only person who understood her. The Registrant’s actions actively undermined Patient A’s husband’s position and placed the Registrant as a positive advocate for Patient A to leave her husband. Such behaviour breached the appropriate professional boundaries that the Registrant should have maintained in respect of this vulnerable patient. The Panel found the Registrant’s statement that he never encouraged Patient A to leave her husband to be implausible.

32. The Registrant’s position, as stated in his response to the concerns raised by Patient A’s GP, was put to Patient A during her oral evidence. She reacted to it with incredulity and disbelief.

33. On the balance of probabilities, the Panel decided that it was more likely than not that the Registrant encouraged Patient A to leave her husband and that in doing so he breached professional boundaries in relation to Patient A.

Particular 1(b) - not proved

34. Patient A said that the Registrant’s involvement with her personal life touched every relationship that she had, including that with her mother, sister, and grandmother. She said that the Registrant wanted her to be more assertive with her family and he suggested what she should write in emails that she would send to them. She said the effect of this was that she became estranged from most of her family and that her sister stopped talking to her. She already had a difficult relationship with her mother, which they had resolved eight years ago by deciding not to speak to each other. She now no longer spoke to her sister either and her contact with her grandmother had lessened considerably. In her statement she said the Registrant “encouraged me to reduce contact with my family, this was part of this creating the new version of me and suggested that I ‘cut them out’.” However, she went on to say that the Registrant did not specifically use that terminology but “he told me that I should say things by text/email that were very out of character for me and would separate me from whatever relationship I had with that member of the family.”

35. In her oral evidence, Patient A said that the reduction in contact with members of her family was the outcome of bad advice given to her by the Registrant, rather than a direct instruction.

36. In his statement dated 8 June 2016, the Registrant said, “I have never told, advised or suggested that [Patient A] break off contact with her family.” He went on to say that Patient A had very difficult relationships with some members of her family, who could be abusive towards her and caused her a lot of stress. He said that a strategy she would use to good effect was to tell her sisters that she was happy to talk to them but not if they were being abusive. He reiterated that at no stage did he tell her to break off communication with her family.

The Panel’s decision

37. The Panel accepted Patient A’s oral evidence that the Registrant encouraged her to stand up to members of her family, with the aim of increasing her assertiveness. The Panel found that a consequence of this was the adoption by Patient A of a change in tone when engaging with her family, which resulted in a reduction in contact. There is no evidence to satisfy the Panel that the Registrant actively encouraged Patient A to reduce contact with members of her family. Accordingly, this particular was not proved.

Particular 1(c) - proved

38. Patient A said that from the beginning of her treatment the Registrant told her to contact him using his personal mobile number and his personal email address. She said that the reasons he gave were that he had problems with signal when using his work mobile, and in relation to the work email there were problems with the Trust server which meant he often did not receive emails sent to his work email address.

39. Patient A produced some screen shots of text messages sent between her and what she stated was the Registrant’s personal mobile phone.

40. AW, in her oral evidence, said that she was not aware of any problems with the Registrant’s work mobile phone or work email account and that the Registrant did not report any such problems to her. She said they had systems in place to deal with faulty mobile phones but she was never called upon by the Registrant to use them. AW said that personal mobile phone numbers and email addresses should never be given out.

41. The Registrant did not mention his personal mobile phone or email in his statement of 6 June 2016, or his letter dated 9 January 2018.

The Panel’s decision

42. The Panel accepted the oral evidence of Patient A that the Registrant told her he was experiencing problems with his work mobile phone’s signal and, as a consequence, gave her his personal mobile number. The Panel took into account the evidence of AW, who stated that she was not made aware of any phone issues by the Registrant and that there was an established process for dealing with any technical issues. AW went on to state that there were no circumstances in which it would be appropriate for the Registrant to give his personal mobile phone number to Patient A.

43. The Panel was satisfied on the evidence that the Registrant did give Patient A his personal mobile phone number and that this breached professional boundaries.

Particular 1(d) - proved

44. Patient A explained that the Registrant made her feel extremely uncomfortable on a regular basis by standing very close to her even if they were in a large space, such as her kitchen. She gave evidence about an occasion when she and the Registrant were considering a document about the model for an FND unit that he wanted to set up and for use in a book that he was writing. She said that, despite there being two sofas available and the fact they each had their own copy of the document, the Registrant had insisted they sit right next to each other on one sofa and look at only one copy of the document. Patient A said that the Registrant pointed at various parts of the page when explaining it to her, touching her leg through the paper, and then rested his hand on her thigh when he had finished. She said “there was no reason for him to stand so close. There was no reason for me to have to sit right next to him. There was no reason for him to touch my leg”. It was another example, she said, of there being “no boundaries at all”.

45. In his letter dated 9 January 2018, the Registrant said, “I deny this allegation, I have never made any physical contact with patient A, appropriate on inappropriate or invaded Patient A’s personal space. Furthermore, patient A or her husband never at any time approached me or suggested any concerns about my contact and interactions with patient A.”

The Panel’s decision

46. The Panel accepted Patient A’s evidence that the Registrant invaded her personal space on more than one occasion by standing too close to her in her kitchen. Further, it accepted her description of an occasion when the Registrant asked her to sit beside him on her sofa to review a shared copy of a document, which she considered unnecessary given that there were two sofas in the room and two copies of the document. She described how he moved sufficiently close to her on the sofa so that his thigh touched hers and then he rested his hand on her lap as he pointed to parts of the document. She described feeling uncomfortable at his actions and being scared.

47. The Panel took into account the Registrant’s letter to the HCPC, dated 9 January 2018, in which he denied this allegation. However, the Panel preferred the evidence of Patient A, which was specific and detailed on this point.

48. The Panel decided that the Registrant’s actions breached professional boundaries and that this particular was found proved.

Particulars 1(e) & 1(f) - proved

49. Patient A said that, following her discharge from NETT, the Registrant continued to visit her, coming to her house weekly on a Monday, and she provided a number of specific dates when he visited. She understood from the Registrant that there was to be a professional role for her in support of the Registrant’s research and the setting up of his ‘model’ for a new unit dealing with FND.

50. HC said that she had been surprised to learn that the Registrant was continuing to visit Patient A after her discharge from the service. HC said that the Registrant was contracted to work 9-to-5 Monday-to-Friday at GSTT and he should have been seeing his NHS patients, not visiting Patient A. HC said that the Trust was unaware of these visits and that they should have been approved and recorded. AW also said that these visits should have been recorded, notwithstanding Patient A’s discharge, and that there was no clear therapeutic or professional reason for the visits, which went far beyond what the Registrant had disclosed to NETT.

The Panel’s decision

51. The Panel decided to consider Particular 1(f) before Particular 1(e) on the basis that its finding in respect of Particular 1(f) would assist its consideration of Particular 1(e).

52. In her witness statement, Patient A listed five dates on which the Registrant “came to [her] house” post her discharge from NETT on 5 February 2016. The Panel also noted the Registrant’s comment in his response to concerns raised by Patient A’s GP that, “my meetings with Patient A post treatment were not in any way secretive.” In her evidence, HC stated that she was not aware of any such meetings or what their purpose might have been. HC confirmed that any meetings that did take place would need to be documented. No such records existed in Patient A’s notes.

53. In her witness statement, Patient A stated that she was unclear about the purpose of these post-discharge meetings. She stated, “I had understood we were no longer ‘doctor’ and patient, yet he continued to ask intrusive and personal questions and observations about my life and my relationships.” She added that he explained that, “obviously he was still monitoring me and making notes. This shocked me. I had not understood that I was being observed as a patient.”

54. The Panel found that the Registrant’s actions in visiting Patient A’s home after discharge breached professional boundaries, in that they were unsanctioned, unsupervised, unrecorded, and there was no evidence that they were clinically indicated. There appeared to be no open, negotiated, and agreed basis for these contacts. Accordingly, the Panel found this particular proved.

55. Having found Particular 1(f) proved, the Panel found that, for the same reasons, the Registrant maintained contact with Patient A following her discharge from NETT, by his visits to her home. There being no clinical justification for this continued contact, it breached professional boundaries in the same way as for Particular 1(f). Therefore, this particular is found proved.

Particulars 1(g) & 1(h) - proved

56. Patient A said that on the last day of her treatment, Friday 5 February 2016, the Registrant took her out to lunch. She said that she knew in advance that they were going to go out to lunch because the Registrant had told her they were going to celebrate that she was well, or at least better than she had been before. However, she had thought they would just be going to a coffee shop or something similar and so she was thrown when the Registrant turned up very smartly dressed in a suit. He did not want to go to a cafe or a pub but somewhere quieter, so Patient A looked on the internet and found a restaurant. She remembered the occasion in detail, including her decision to change into something smarter because of his appearance and the fact that they were going to a restaurant. She remembered the specific clothes she wore and what they ordered from the menu. She remembered him ordering an expensive bottle of wine and then later having an additional large glass of wine after the bottle had been finished.

57. Patient A said that she felt very awkward during the meal. She said it felt like they were “a couple out for an intimate meal.” She said they were sitting close together, there were lots of silences, and she felt like the Registrant was staring at her. She said she did not really understand the nature of their relationship at that time and she did not want to be there. She also remembered feeling “terrified" about being driven home by the Registrant in the knowledge that he had had quite a bit of wine to drink. She said that she would not get into a car with her husband if he had drunk even half a glass of wine, but she was scared of upsetting the Registrant and would have done anything he told her to do.

58. AW said that it was not appropriate to take a patient out to lunch if it was not part of a rehabilitation program.

59. In his statement dated 8 June 2016, the Registrant said he did not go out to lunch with Patient A.

The Panel’s decision

60. In her evidence, Patient A provided a vivid and detailed account of being taken out to lunch by the Registrant on 5 February 2016. The Panel took into account the Registrant’s denial that he had taken Patient A out to lunch. The Panel noted, however, that the Registrant’s diary for that date recorded a meeting with Patient A between 1200-1400 hours. In light of that, and Patient A’s clear and detailed description of the lunch, the Panel considered it more likely than not that the Registrant took Patient A out to lunch on 5 February 2016. In her oral evidence, Patient A described her recollection as being “as clear as day.” She said that “we were like a couple” and she recalled the Registrant saying words to the effect that “I am the one who knows you better than anyone else in the world.”

61. In her evidence, AW stated that “it is not appropriate to take a patient out for lunch if it is not part of a rehabilitation programme.” There was no evidence before the Panel to suggest that the lunch was part of a rehabilitation programme, nor did Patient A’s description of the occasion sit with such a purpose. Accordingly, the Panel found that the Registrant’s behaviour breached professional boundaries.

62. Patient A gave a clear account of the Registrant ordering an ‘expensive’ bottle of wine, which they shared over lunch. Her further recollection of observing the Registrant at the restaurant bar ordering a large glass of wine, after they had finished the bottle, added credibility to her account of events. The Panel accepted Patient A’s evidence.

63. AW stated that there were no circumstances in which it was suitable to consume alcohol during working hours. The Panel found that the Registrant breached professional boundaries through his actions in ordering a bottle of wine.

Particular 1(i) - proved

64. Patient A said the Registrant asked her to appear in an article in the GSTT magazine to share her experience of FND and, to that end, she had an interview with a journalist. She then said that, during a session with the Registrant after that interview and after discharge from NETT, she asked the Registrant what their relationship was, given he was no longer officially treating her. Patient A said that the Registrant said something along the lines of “our relationship will change. Right now we’re doctor and patient, we’ll move beyond that and we’ll start to become friends and maybe more.”

65. In her oral evidence Patient A was able to describe how the conversation took place whilst they were sitting on a sofa upstairs in her daughter’s bedroom after the third attempt at making a video interview with the Registrant about her FND experience. She said she interpreted his meaning in relation to ‘more’ to be referring to the possibility of a romantic and/or sexual relationship.

66. The Registrant, in his letter dated 9 January 2018, denied saying any such thing.

The Panel’s decision

67. In her witness statement, Patient A stated that, “During one session, after the interview I cannot recall the exact date but it was certainly after [the Registrant] was officially treating me, I asked what our relationship was. [The Registrant] had said something to me along the lines of ‘our relationship will change. Right now we’re doctor and patient, we’ll move beyond that and we’ll start to become friends and maybe more’.” In her oral evidence, Patient A said that the Registrant’s remarks had scared her and opined that it indicated a more personal interest. Perhaps his intention, she observed, was to develop not only a professional but a more personal relationship.

68. The Panel took into account the Registrant’s response to this allegation. However, it found Patient A’s evidence to be detailed and consistent and considered her to be a credible witness. The Registrant had not attended and it was difficult to assess his credibility on the basis of the documentation alone. However, the Panel kept in mind that it was for the HCPC to prove its case, not for the Registrant to disprove it. In all the circumstances, the Panel preferred the evidence of Patient A to that of the Registrant’s denial and, on the balance of probabilities, considered it more likely than not that the Registrant used those, or similar, words. Such behaviour clearly, in the Panel’s view, breached professional boundaries.

Particulars 2(a) & 2(b) - proved

69. Throughout her evidence Patient A detailed how the Registrant exercised power and control over her. She described how, as her sessions with the Registrant progressed, she felt she was living in two worlds—her normal one and the Registrant’s one—but that she was being sucked more and more into the Registrant’s world. She felt increasingly isolated and came to depend heavily on the Registrant. She felt completely under his influence and unable to say no to him. She repeatedly referred to the fact that “you cannot say no to the man who rescued you”. She said she reached a stage where she went along with everything that he said. “It wasn’t me” she said, “I was just a shell.”

70. Patient A said that the Registrant told her he was planning to set up his own unit specialising in FND and he wanted to interview her as evidence of what a harrowing experience it was to be an FND patient because it is an unknown condition. She said she was to be his case study, although she later felt more as if “he used me as a case specimen like in a jar.” Patient A said that when the Registrant asked her to assist she said, “you know I don’t want to but you know I will.” Patient A said she felt obligated because she had gone from not being able to walk to walking. She understood that the video was to be used as a training tool for medical professionals coming into contact with FND patients for the first time.

71. She described how they had four filming sessions lasting many hours. The first was two days before her treatment ended on 5 February 2016 and the following videos were after treatment had ended. She said that making the videos was an extremely traumatising experience, which she hated and never wanted to do. She said she did not sign anything to say that she had consented to being filmed and she had no real understanding of the extent to which the Registrant would share the videos. She said that the only written consent she had ever given was to the journalist for the GSTT article, which she later withdrew.

72. Patient A said that her understanding of her role in relation to the academic article the Registrant was writing was one of professional collaborator and not one of patient. She said, “he was still seeing me as a patient and without my knowledge.” She said that she was not aware that the Registrant continued to take notes during their sessions after discharge and she felt “completely betrayed” to discover this was the case. Patient A said she felt physically sick when she read the completed article and that the Registrant had twisted her words to suit his agenda.

73. Both AW and HC gave evidence about the process that the Registrant should have followed to obtain consent from Patient A. HC said she directed the Registrant in writing to complete the necessary processes, but he failed to do so. AW and HC said that Patient A’s discharge did not change the requirement to obtain consent. AW confirmed that there was no record of any consents having been obtained by the Registrant anywhere in Patient A’s records at NETT.

74. In his June 2016 statement, the Registrant said, “The consent for these videos and the videos that were taken during her treatment period as far as I am aware are on file at the NETT office.” In relation to the article, the Registrant said that he and Patient A had discussed consent and agreed that a signed consent by Patient A “would be taken once the manuscript was completed and ready for submission to a professional journal and that [Patient A] was happy with the contents. To date the manuscript remains uncompleted and consequently has not been submitted for publication …”

The Panel’s decision

75. The Panel was satisfied based on the evidence of AW and HC that the Registrant had a duty to obtain consent from Patient A in respect of taking notes and including her information in an article, and in respect of conducting video interviews and/or subsequently using the video interviews. Further, the Panel found, also on the basis of AW and HC’s evidence, that the Registrant would have been aware of that duty. The Panel decided that such consent should have been informed, documented, and specific for the purpose for which it was required.

76. The Panel accepted the evidence of AW and HC that such consent should be obtained at the start of any such process. There was no evidence before the Panel that the Registrant obtained consent in the form described above in respect of notes, articles, or videos, and the Panel therefore found both these particulars proved.

Particulars 3(a), 3(b)(i) & (ii), 3(c), 3(d) & 3(e) - proved

77. In her evidence, AW said that after the safeguarding alert was raised she undertook an audit of the notes for patients that the Registrant had been involved with. She told the Registrant that she needed all his notes and his diary. The Registrant said that he had some notes at home. He came in the next day with handfuls of handwritten patient notes which, AW said, were in complete disarray. He then spent the next two and half hours sorting out the notes into individual patients. When this was completed, AW saw that there were no notes for Patient A. She subsequently, when going through all the notes, found two handwritten notes for Patient A. This surprised her since he had carried out numerous sessions with Patient A and there should have been notes for every session. AW produced the two handwritten notes, one of which was written on the back of a patient summary sheet containing other patient details and the other written on rough paper. AW said there should also have been records by the Registrant under the electronic patient care note system for Patient A, but there were none.

78. AW said she asked the Registrant to provide the discharge summaries for all his patients. She did not mention that it was Patient A she was specifically interested in. AW said that the Registrant then sent two discharge summaries to her but not one for Patient A. Such summaries, she said, should be completed within one week after discharge. AW said she then checked Patient A’s records and found a discharge summary. She said that because Patient A was being seen by a multi-disciplinary team, each discipline should write their report on the discharge summary. On the discharge summary for Patient A, all the other disciplines involved had written their reports, but there was not one by the Registrant as there should have been. She therefore contacted him because she was concerned that he had not completed his discharge summary for Patient A, who had been discharged on 5 February 2016 and it was by then May 2016. She then received a document from the Registrant for Patient A.

79. Having read the document that the Registrant belatedly sent in for Patient A, AW said that she was very concerned about the style in which the summary had been written. She said the document was not written in the usual format and within it the Registrant had written that Patient A had made a prior complaint about care received before she came to the NETT. AW did not know how Patient A having made a complaint could be relevant to any part of the discharge summary. AW thought that the Registrant might be trying to highlight that Patient A had a habit of raising complaints.

80. AW said that she requested Dr NT, Head of Psychological Services/Consultant Health Psychologist at GSTT, to carry out an independent review of the Registrant’s notes that did exist in relation to Patient A. Dr NT concluded as follows:

• in relation to electronic care notes, there was a complete absence. The expectation is that psychologists always document a summary of the assessment that includes a brief formulation of presenting problems/issues, identify any risk factors that may pose a risk to patients’ self and others, be very clear if there is mood disorder like depression/anxiety present and the plan of treatment, what the nature of treatment would be and the frequency of sessions. For follow-up sessions the notes would include progress, the nature of the intervention and a plan to support the next meeting;

• in relation to the two paper notes, they were in very poor order. One set was written on the back of a used NETT patient summary sheet (this included five other patients’ names, hospital numbers, diagnosis, discharge dates and comments on their biopsychosocial issues). The other was written on rough paper and mostly illegible;

• the ‘discharge summary’ sent in by the Registrant was an undated Word document, which did not state: the focus of therapy; the nature of the therapy; information about objective neuro-psychologiocal assessment and implications; whether any mood assessments were done/recorded and what these were on discharge; and it did not state any suicide risk or other risk factors if appropriate. It was very surprising that he put in the discharge notes that [Patient A] “made a complaint about her treatment and diagnosis to PALS”.

81. AW also gave evidence about how the videos of Patient A that the Registrant was responsible for should have been put onto a GSTT USB stick and saved confidentially with Patient A’s records. She said she reviewed the records and could find no record of the videos.

82. HC also gave evidence about the Registrant’s duty to maintain adequate records in relation to Patient A.

The Panel’s decision

83. The Panel was satisfied from the evidence of AW and HC that the Registrant had a duty to maintain adequate records in relation to Patient A and that he was aware of that duty. AW stated that this was a legal requirement and that it was imperative records be completed.

84. In relation to Particular 3(a), HC confirmed, in answer to questions from the Panel, that the Registrant did not record any entries in Patient A’s electronic care notes. Accordingly, this particular was found proved.

85. In relation to Particular 3(b)(i) and Particular 3(b)(ii), the Panel was satisfied from its examination of the paper notes that they were written on the back of a patient summary sheet and also on rough paper. The Panel considered this to be inappropriate and did not amount to adequate record-keeping. Furthermore, there should have been many more records to cover the multitude of long sessions that the Registrant carried out with Patient A. The Panel therefore found this particular proved.

86. In relation to Particular 3(c), the Panel accepted the evidence of AW that the Registrant did not complete the required section of the electronic discharge summary and found this to be consistent with the copy of that summary produced in evidence, which showed a blank space under the heading ‘Neuropsychology.’ Accordingly, the Panel found this particular proved.

87. In considering Particular 3(d), the Panel took into account a written document produced by the Registrant and introduced as Exhibit 13 by AW. Whether or not this document was taken as a discharge summary, the Panel found that it was not of an adequate standard for that purpose. The Panel’s finding in this regard was informed by Dr NT’s assessment of the document and the evidence of AW. Particular 3(d) was therefore found proved.

88. The Panel found that there was no evidence that the Registrant stored the videos of Patient A either with the paper records or the electronic records. Accordingly, the Panel found Particular 3(e) proved.

Particular 4 - proved

89. Patient A said that at one point during the therapy she started to feel better and she explained to the Registrant that she did not understand the work the NETT did. She said she asked him if he had tried the same treatment style on other patients. In response, she said the Registrant started to talk in detail about two patients, including providing the name of one of them and sufficient details about the other for AW and HC to identify who that patient was.

90. AW said that when she read Patient A’s statement that the Registrant had shared confidential information about other service users, she realised that some of the information Patient A provided “she should definitely not have known about.” She said she was able to identify the individuals concerned from the detail provided by Patient A. AW said she was concerned because divulging confidential information relating to other patients should not be done without express consent.

91. In his 8 June 2016 statement, the Registrant said, “I have never disclosed any information to [Patient A] about other patients. We have had general discussions about the difference between functional neurological disorder (FND) patients with chronic problems compared to acute patients experiencing FND episodes. She was very interested in the different stages of FND from a personal perspective and also how these types of patients could be supported within a service.”

The Panel’s decision

92. In her evidence, Patient A stated that the Registrant had, in respect of two patients, shared with her confidential information, including their names, background, symptoms, diagnoses, life experiences, stress triggers, and family details. In their evidence, both AW and HC were able to identify the two patients concerned from the information given to them by Patient A.

93. The Panel was satisfied, on the balance of probabilities, that it was more likely than not that it was the Registrant, and not someone else, who passed this detailed information to Patient A. The Panel took into account the Registrant’s account that he “never disclosed any information to [Patient A] about other patients.” However, the Panel considered this to be implausible in light of the detailed, credible evidence given by Patient A, as supported by the evidence of AW and HC. Accordingly, the Panel found this particular proved.

Particular 5 - proved

94. Patient A said the relationship with the Registrant felt odd from the start. She said that from the outset he presented himself as very informal, relaxed, and jokey “as though he was not taking anything too seriously.” She said their relationship did not feel particularly professional and it did not seem that there were any boundaries. She also described the Registrant’s behaviour as ‘flirtatious'. She was disturbed by the Registrant’s attempts to drive a wedge between her and her husband. She was disturbed by the frequent intimate questions the Registrant would ask about their sexual relationship. She was disturbed by his desire to conduct therapy sessions upstairs in her bedroom, which she declined, instead choosing to use her daughter’s bedroom. She was disturbed by his physical closeness and invasion of her personal space and also his touching her on the leg as described above. She also felt distinctly uncomfortable being taken out to lunch by the Registrant and she felt his comments, as found proved at Particular 1(i), suggested he was interested in a romantic and/or sexual relationship with her.

95. In his letter dated 9 January 2018, the Registrant denied any sexual motivation in his behaviour toward Patient A and insisted that he had always conducted himself in a professional manner.

The Panel’s decision

96. In considering this particular, the Panel was mindful of the guidance offered in Section 78 of the Sexual Offences Act 2003, which provides that an act will be sexual if:

(a) whatever its circumstances or any person’s purpose in relation to it, it is because of its nature sexual, or

(b) because of its nature it may be sexual and because of its circumstances or the purpose of any person in relation to it (or both) it is sexual.

97. The Panel’s findings in relation to Particular 1 indicate a developing pattern of behaviour by the Registrant involving:

• progressive isolation of Patient A, particularly from her husband;

• the establishment of dependency of Patient A upon, and a sense of obligation towards, the Registrant;

• the establishment of an informal and increasingly intimate relationship with Patient A;

• inappropriate physical contact;

• an element of grooming;

• a climate of secrecy.

98. Patient A described the Registrant’s behaviour as flirtatious “right from the start”. The Registrant’s actions in relation to taking Patient A out for lunch, including the purchase of wine, and his later words at Particular 1(i) about starting to become friends and maybe more, were illustrative of the development of the pattern of behaviour.

99. The Panel noted Patient A’s evidence that the Registrant conducted interviews with her in an upstairs bedroom in an otherwise empty house and that Patient A felt the need to cover her body. His questioning routinely focused on intimate details of her sexual relationship with her husband and she described him making suggestions about sexual activity between her and her husband. There was no evidence before the Panel that this was justified or necessary as part of the treatment plan.

100. In all the circumstances, the Panel was satisfied, on the balance of probabilities, that sexual motivation formed a part of the pattern of behaviour reflected in Particular 1 and, accordingly, found Particular 5 proved.

Decision on Grounds

101. The Panel next considered whether the facts found proved amounted to misconduct. In so doing it took into account all the evidence and the submissions made by Ms Chaker. The Panel accepted the advice of the Legal Assessor.

Particular 6 - Misconduct made out

102. The Panel found that the Registrant’s actions in respect of breaching professional boundaries, failing to obtain proper consents, record-keeping, breaching patient confidentiality, and acting with a sexual motivation fell seriously short of what would have been proper in the circumstances. The Panel was in no doubt that fellow members of the profession would consider the Registrant’s conduct to be deplorable. The Panel concluded that the Registrant’s behaviour amounted to misconduct. In reaching this decision the Panel found breaches to the relevant HCPC Standards, as set out below.

103. In relation to matters before 26 January 2016, the Panel found the Registrant to be in breach of the following parts of the HCPC Standards of Conduct, Performance and Ethics (2008-2016) applicable to all HCPC Registrants:

1 You must act in the best interests of your patients, clients and users

2 You must respect the confidentiality of service users

3 You must keep high standards of personal conduct

9 You must get informed consent to provide care or services (so far as possible)

10 You must keep accurate patient, client and user records

14 You must behave with integrity

16 You must make sure that your behaviour does not damage your profession’s reputation

104. In relation to matters after 26 January 2016, the Panel considered the Registrant to be in breach of the following parts of the HCPC Standards of Conduct, Performance and Ethics (2016-present) applicable to all HCPC Registrants:

1.4 You must get informed consent to provide care or services (so far as possible)

1.7 You must keep your relationships with service users and carers professional

5.1 You must treat information about service users as confidential

5.2 You must only disclose confidential information if:– you have permission;– the law allows this;– it is in the service user’s best interests; or– it is in the public interest, such as if it is necessary to protect public safety or prevent harm to other people.

9.1 You must make sure that your conduct justifies the public’s trust and confidence in you and your profession

10.1 You must keep full, clear, and accurate records for everyone you care for, treat, or provide other services to.

10.2 You must complete all records promptly and as soon as possible after providing care, treatment or other services

10.3 You must keep records secure by protecting them from loss, damage or inappropriate access

105. The Panel found there to be breaches of the following parts of the HCPC Standards of Proficiency for Practitioner Psychologists (2015-present):

2.1 understand the need to act in the best interests of service users at all times

2.6 understand the importance of and be able to obtain informed consent

2.7 be able to exercise a professional duty of care

2.9 understand the power imbalance between practitioners and service users and how this can be managed appropriately

2.10 be able to recognise appropriate boundaries and understand the dynamics of power relationships

3.1 understand the need to maintain high standards of personal and professional conduct

10.1 be able to keep accurate, comprehensive and comprehensible records in accordance with applicable legislation, protocols and guidelines

10.2 recognise the need to manage records and all other information in accordance with applicable legislation, protocols and guidelines

106. Having found the facts proved amounted to misconduct, it was not necessary for the Panel to consider the alternative statutory ground of lack of competence.

Decision on Impairment

107. Having found the statutory ground of misconduct to be well founded, the Panel went on to consider whether the Registrant’s current fitness to practise was impaired as a result of that misconduct. In doing so it took into account the submissions made by Ms Chaker and accepted the advice of the Legal Assessor.

Particular 7 - current impairment found

108. The Panel found numerous widespread failings in fundamental aspects of the Registrant’s practice, together with gross breaches of personal boundaries, which the Panel found to be sexually motivated. There was no evidence before the Panel that the Registrant had any meaningful insight into his conduct and the impact of his behaviour on Patient A, the public, and the profession. There was no suggestion that he considered that he had done anything wrong or that his actions have had a seriously adverse impact on Patient A. Although some of the Registrant’s misconduct is capable of remediation in theory, there was no evidence of remediation having been attempted or achieved. The sexually motivated behaviour is suggestive of a deep-seated attitudinal issue, which may be more difficult to remediate. In all the circumstances, the Panel considered there to be a real risk that the Registrant would repeat his behaviour.

109. The Panel considered that three of the four criteria identified by Dame Janet Smith in the 5th Shipman Report were engaged in this case. The actions of the Registrant placed Patient A at real risk of harm and the risk of repetition means that he is liable to place patients at unwarranted risk of harm in the future. His wholesale failings, not least in acting with a sexual motivation, have brought his profession into disrepute and with no insight or remediation, the Panel was of the view that he was liable to do so again in the future. The Panel had identified numerous standards that the Registrant has breached and found that this amounts to a breach of the fundamental tenets of the profession. There remains a risk of repetition in the future. The Panel therefore found the Registrant’s fitness to practise currently impaired on the grounds of public protection.

110. The Panel went on to consider whether this was the type of case that required a finding of impairment on public interest grounds in order to maintain public confidence in the profession and the Regulator. The Panel was satisfied that a fully informed member of the public, who was aware of all the background to this case, would have their confidence in the profession and the Regulator undermined if a finding of impairment were not made, given the nature and seriousness of the Registrant’s misconduct in a number of areas fundamental to his professional practice, which included behaving in a sexually motivated way towards a particularly vulnerable patient in his care.

111. The Panel therefore determined that the Registrant’s fitness to practise is currently impaired both on public protection and public interest grounds and that the allegation of impairment is well founded.

Decision on Sanction

112. In reaching its decision on sanction, the Panel took into account the submissions made by Ms Chaker, together with all the written evidence and all matters of personal mitigation. The Panel also referred to the guidance issued by the HCPC in its Indicative Sanctions Policy. The Panel had in mind that the purpose of sanctions was not to punish the Registrant, but to protect the public, maintain public confidence in the profession, and maintain proper standards of conduct and performance. The Panel was also cognisant of the need to ensure that any sanction is proportionate. The Panel accepted the advice of the Legal Assessor.

113. The Panel considered the aggravating factors in this case to be:

• the serious impact on Patient A resulting from the Registrant’s actions;

• that Patient A was a particularly vulnerable patient;

• a gross breach of trust and abuse of the power imbalance that exists between a psychologist and a patient;

• the pernicious, manipulative and predatory behaviour which resulted in Patient A feeling totally dominated by the Registrant;

• the Registrant using Patient A to further his own personal and professional agendas, using her as a case study;

• the serious breaches across a wide range of fundamental and professional principles and standards;

• the Registrant’s failure to acknowledge the serious impact of his actions on Patient A.

114. The Panel considered the following mitigating factors:

• this is the first time that the Registrant has been subject to proceedings before the HCPC.

115. In the absence of the Registrant, the Panel had no evidence before it of any other mitigating factors and it was clear that the aggravating factors far outweighed the mitigation.

116. The Panel approached the ladder of sanction, beginning with the least restrictive sanction. In light of the seriousness of the conduct, the Panel did not consider this was an appropriate case to take no further action or consider mediation, since neither would protect the public from the risks identified by the Panel or reflect the seriousness of the misconduct.

117. The Panel then considered whether to caution the Registrant. However, the Panel was firmly of the view that such a sanction would not reflect the seriousness of the misconduct in this case. The Registrant breached professional boundaries with a particularly vulnerable patient and the Panel found that his behaviour was, amongst other things, sexually motivated. He also failed to obtain proper consent, failed to keep proper records, and breached patient confidentiality by discussing details of two other patients with Patient A. The Panel has already concluded that there is a risk of such behaviour being repeated given the complete absence of insight shown by the Registrant and the complete lack of evidence of remediation. A caution, therefore, would not protect the public from any such risk. The Panel was also of the view that public confidence in the profession, and the HCPC as its Regulator, would be undermined if such behaviour were dealt with by way of a Caution.

118. The Panel next considered whether to place Conditions of Practice on the Registrant’s registration. The Indicative Sanctions Policy states that before imposing Conditions of Practice, a Panel should be satisfied that:

• the issues which the conditions seek to address are capable of correction;

• there is no persistent or general failure which would prevent the registrant from doing so;

• appropriate, realistic and verifiable conditions can be formulated;

• the registrant can be expected to comply with them; and

• a reviewing Panel will be able to determine whether those conditions have or are being met.

119. The Panel also noted from the Indicative Sanctions Policy that Conditions of Practice will rarely be effective unless a registrant is genuinely committed to resolving the issues they seek to address and can be trusted to make a determined effort to do so. Therefore, Conditions of Practice are unlikely to be suitable in cases:

• where the registrant has failed to engage with the fitness to practise process, lacks insight or denies any wrongdoing;

• where there are serious or persistent overall failings; or

• which involve dishonesty, breach of trust or the abuse of service users.

120. The Panel considered that ordinarily some of the failures in this case, such as the record-keeping failures, could be addressed by Conditions of Practice. However, acting in a sexually motivated way towards a patient is not something easily addressed by way of conditions. Furthermore, the Registrant has not engaged with this process, lacks insight, and has denied any wrongdoing, so it could not be known if he was committed to resolve the issues the conditions would seek to address or could be trusted to make a determined effort to do so. His misconduct included a breach of trust and the Panel was unable to formulate workable conditions that would not be so restrictive as to amount to suspension by another name. Even if it had been possible to formulate conditions, the Panel did not consider that a Conditions of Practise Order would adequately reflect the seriousness of the Registrant’s misconduct in this case.

121. The Panel next considered whether to make a Suspension Order. The Indicative Sanctions Policy states that, “Suspension should be considered where the allegation is of a serious nature but unlikely to be repeated and, thus, striking off is not merited.” The Panel reminded itself of its earlier findings of a complete absence of insight, a sexual motivation, the abuse of a position of trust of a highly vulnerable patient, and the real risk of repetition. Although a Suspension Order would provide protection to the public for its duration, the Panel was not satisfied that it would be sufficient to maintain public confidence in the profession or the regulatory process, or to send a clear message to the profession at large that such behaviour would not be tolerated. The Panel determined that a Suspension Order would not be a sufficient sanction in the circumstances of this case.

122. The Panel therefore looked at the guidance in the Indicative Sanctions Policy on making a Striking Off Order, in order to decide whether such an Order would be appropriate. The guidance states that, “Striking off is a sanction of last resort for serious, deliberate or reckless acts involving abuse of trust such as, sexual abuse, dishonesty or persistent failure.” It goes on to observe that “Striking off should be used where there is no other way to protect the public, for example, where there is a lack of insight, continuing problems or denial. A Registrant’s inability or unwillingness to resolve matters will suggest that a lower sanction may not be appropriate.” The Panel finds that this case is characterised by denial, a gross abuse of trust, sexually motivated acts, a complete lack of insight, and no remorse.

123. The Indicative Sanctions Policy goes on to suggest that a Striking Off Order may be appropriate where the nature and gravity of the allegation are such that any lesser sanction would lack deterrent effect or undermine confidence in the profession. The Panel’s earlier finding in relation to the consideration of a Suspension Order identified that a lesser sanction would indeed be insufficient to represent these wider public interest issues in the specific circumstances of this case.

124. A psychologist often works autonomously and must be trusted to work transparently and collaboratively, to maintain professional boundaries, and not act as a sexual predator, abusing the position of trust they are in and the power imbalance they have over vulnerable patients. Furthermore, they must keep accurate and appropriate records. A failure to do so puts patient care at risk and makes it extremely difficult for other health care professionals who might be involved in the care of those patients to know what treatment has been provided and the efficaciousness of that treatment. The Panel has found that the Registrant failed to act in the best interests of Patient A in many different respects and decided that there continues to be a risk that he would do so in the future.

125. The Panel concluded that, in light of the seriousness of the misconduct and the lack of insight and remediation, leaving a real risk that the behaviour would be repeated, the only appropriate sanction in this case was to make a Striking Off Order. The Panel took into account the impact this would have upon the Registrant, but concluded that the need to protect the public outweighed his interests and that no other sanction would adequately protect the public.

126. Accordingly, the Panel makes a Striking Off Order and directs the Registrar to erase the name of Dr Darren Mockler from the Register.

Order

That the Registrar is directed to strike the name of Darren Mockler from the Register on the date this order comes into effect.